LDL Cholesterol

Hello all.

I’m wondering what other people with diabetes do to better their LDL cholesterol levels? Are you on a statin? What kind and how much? Do you tolerate statins at low doses only or can you take higher doses? Can you attribute a lifestyle factor which helps to lower your LDL?

I’m on 10mg of Lipitor and have an LDL of 85. I thought this is a good number, but my doctor would like it to be 50 or lower. I don’t tolerate statins well, so I’m hoping for other options.

Richard @Richard157 I read your awesome book; thank you for sharing your story! Your book is what brought me to ask the question above because I saw where your LDL was 52! How do you accomplish this?

Part of it is genetic. I can try very hard and never reach the levels of my wife. But diet and exercise can help.

Your LDL is 85, but what is your HDL and triglycerides? And do you know the size of your particles? Big and fluffy LDL is safer than small dense LDL particles.

Ask your doctor for a NMR lipo-profile. NMR stands for “Nuclear Magnetic Resonance”. It is a cholesterol test which gives more information than a standard test.

But to answer your question - diet and exercise, and also psyllium can help. That is a natural product.


A couple of non-statin approaches I’ve found to help keep mine in the healthy range (similar to Eddie2’s comments):

  • Intense exercise, including resistance work (I do Olympic Lifting)

  • Low-carb eating: I find this irritating, but it works in both keeping BG under control and in managing LDL and Triglycerides (especially Triglycerides)

  • High Dose Omega-3 fish oil tends to lower LDL and raise HDL

  • Therapeutic dose Niacinamide is an irritating supplement to take, but is very effective in lowering LDL and triglycerides. It causes a “flush” which can be both irritating (sometimes painful) and embarassing (lobster, anyone?) for a couple hours after taking a dose, but I’ll put up with that over the side-effects of statins (to which I’m allergic).

Hello @Tapestry, I am pleased that you liked my book.

I have not used Lipitor, but mt wife did. It had bad side effects for her, It messed with her head, and she had difficulty organizing her thoughts.
I am currently using Rosuvastatin (generic form of Crestor). My recent Lipid Panel is:

Total Cholesterol…145

I am experiencing a lot of fatigue and weak muscles. I don’t think that is caused by the statin, maybe it is just old age…I am 78 with 72 yrs of T1 now.

I cannot do strenuous exercises now, but I take long one hour walks on roads with hills, and I workout at the gym with muscle conditioning machines. I get too tired to do more than one hour of gym or walking in a day.
I have used Omega-3 fish oil for more than 5 years.

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Both my parents had bad side effects from statins, so I have been determined to stay away from them as much as possible. Diet and exercise helped some for me, but lately, that has been failing to make the difference my doctors (and I) want.
Six months ago, my Lipids Profile was: Total: 242, Trigs: 62, HDL: 54, LDL: 170.

Keeping my BG in check (low carb eating and A1c in the mid-to-low 5s) has helped at least with triglycerides. All that said, I did try - at my endo’s insistence - a very low dose (10mg bi-weekly) of pravastatin – and had side effects that got progressively worse with each dose. I’d be due for one tomorrow, but plan to skip taking it.
My endo pursued and won approval for me to take Praluent - an injectable PCSK9 inhibitor that reduces serum LDL cholesterol by allowing the body to eliminate it more efficiently.

After one month on Praluent, my Lipids Profile is as follows: Total: 115, Trigs: 65, HDL: 49, LDL: 53.

I think that is a significant-enough improvement to keep taking it for now. I have had no serious side effects from Praluent - just a dry cough for 2-3 days, but that seems to be less with each dose.

Thank you, @Eric2! I forgot about genetics, although I don’t think mine is as bad as it could have been. I have a few cousins who have very high cholesterol who are strict vegetarians (3-400+ if I remember correctly as it’s been years since they passed away).

My numbers, which are all in a fair/good range, do not reflect their plight. My total is 137, triglicerides at 93, and the hdl at 45.

I’m going to ask about that test. I’ve never heard of it before.

My diet hasn’t been the best lately, so I can improve on that and the exercise too. The psyllium is new to me. I’ll look into it.

Thank you so much!

Thank you, @David49 for replying. I am far from Olympian abilities, although I could (and will) definitely increase my exercise.

I can definitely improve on my diet too. I was following a more low carb approach, but I fell into the downward spiral of having just one, which led to two, which led… I can (and will) get back on that path.

My husband takes fish oil. I’ll start taking that. I’ve heard it has heart benefits as well.

The Niacinamide doesn’t sound like something I’d like to take. I suppose if it were taken at bedtime, you could avoid the embarrassing appearance, but the pain might make sleep impossible. If all else fails, it’s good to know though, so I might find myself taking it.

Thank you again for replying.

Hello @Richard157 Richard157. I enjoyed your book immensely! What an amazing life you have led!

Your numbers are wonderful. I’m hoping to up my hdl and lower the ldl. From what has been said here, it appears increasing my exercise and following a lower carb diet will help a lot. I have a lot of fatigue and I’m trying to work past it. I have hope.

I’m going to start taking fish oil pills.

Thank you again for replying and for taking the time to share your amazing story.

Thank you @Thas for replying. My parents have passed and I don’t recall them taking any statins, but they worked at controlling their cholesterol with their diet.

The difference is amazing between your two profiles. Wow. Your numbers are great. It’s good to hear that you don’t have much in the way of negative side effects either.

The doctor did suggest pcsk9s but I was quite leery of them. I’ve heard about them on commercials but never from someone who has taken them. That and it seemed like I had to take both, the statin and the pcsk9. It’s good to know that isn’t always the case.

Thank you for replying.

Do you have other risk factors for cardiovascular disease? Why is your doctor pushing for a MUCH lower number than the regular recommended range? Statins (like any drugs) have their own risks and I’d think you’d want to balance risk and benefit. Given your LDL level of 85, I see little benefit to adding them. (I personally refuse to take them as a “standard” addition for diabetics.)

ETA: Also meant to mention that fiber intake (from whole, clean foods, not supplements) has a beneficial lowering effect on LDL.

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Richard157 would you mind sharing the name of the book that you recommended to Tapstry?

I can hardly believe that you have lived so long with diabetes with few complications. You are indeed an inspiration to me! I’ve had it coming on 60 years but have had a major complicalication that being my heart.

I am thankful everyday to still be vertical, haha!

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Hi @Jane22. my book was published in 2010 and it gives the diabetes history for my first 64 years, starting in 1945. It can be found on Amazon. Here is the link:

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Richard157, thanks so much! I’ll be ordering it today! I was diagnosed in 1958 so I imagine I can relate with some of the similar experiences you had back then.

What a journey we’ve been on!

Thanks again!

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Hello @Dessito

I don’t have any heart problems and have successfully passed a cardiac stress test, but I do have vascular disease, so there is, at the present time, benefit to achieving a lower LDL - hopefully without increasing the statin dose. I didn’t realize when the doctor suggested lowering it, that there were different acceptable values depending upon what they call risk factors.

Thank you so much for the suggestion of natural fiber, which upon checking, I do eat often in the form of vegetables, fruits, and nuts. I guess it just isn’t enough to show a significant difference. Although, I’ve always eaten fiber rich foods, albeit without knowing it, so I can’t say what my LDL would be if I didn’t.

I have labs results! I’m happy to say that my lipid levels are great :slight_smile: My LDL is where my doctors want it. I just saw the cardiologist after the lab reports were in and I mentioned I had begun learning and experimenting with a keto diet in early April and it’s working … that, and reluctantly I did increase my Lipitor to 20mg! A far cry from the 80 mg and pcks9s they wanted me to take. The cardiologist wants to run further tests, just to be sure all is okay or to at a minimum, have a baseline, as to any cardiac artery disease. That is forthcoming in the next few months. Once I have about six months of keto under my belt, I’m planning on reducing the Lipitor back to 10 mg and after six months to nothing. Time will tell if my body will be able to do it or not.

I want to say thank you to everyone for your kind words of support and encouragement!